title: Comparison of high-dose salmeterol/fluticasone and moderate-dose salmeterol/fluticasone plus low-dose mometasone in patients with severe persistent asthma.
abstract: OBJECTIVE
  The effects of adding a second inhaled corticosteroid with a different particle size, compared with using an increased dose of a single inhaled corticosteroid, were assessed in patients with persistent asthma.
  
  
  METHODS
  This was an open-label study of Japanese asthma patients over 20 years of age. After a 1-month run-in period, 36 patients with inadequate control while using salmeterol/fluticasone propionate 50/250 µg (SFC50/250) bd, were randomized to receive SFC50/500 bd or SFC50/250 plus mometasone 100 µg bd (SFC50/250/MF100) for 2 months.
  
  
  RESULTS
  Both treatments resulted in improvements in morning and evening PEF. There were no significant changes in FEV(1) , maximum mid-expiratory flow, maximum expiratory flow rate at 50%, maximum expiratory flow rate at 25% or exhaled NO (FENO) in the SFC50/500 group. On the other hand, there were significant improvements in FEV(1) % (+12.2%, P = 0.0142), %maximum mid-expiratory flow (+28.9%, P = 0.0181), %MEF50 (+32.4%, P = 0.0206) and %MEF25 (+30.3%, P = 0.0113) in the SFC50/250/MF100 group. The changes in FENO (-23.2% (P = 0.0157) in the SFC50/250/MF100 group and -14.5% (not significant) in the SFC50/500 group) did not differ significantly between the groups.
  
  
  CONCLUSIONS
  In patients with severe persistent asthma, addition of low-dose mometasone to SFC50/250 improved spirometric parameters, FENO and PEF, while an increase in dose from SFC50/250 to SFC50/ 500 only improved PEF.
authors.affiliation: Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan. a1091749@pref.saitama.jp
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kurashima
authors.forename: Naho
authors.initials: N
authors.lastname: Kagiyama
authors.forename: Noboru
authors.initials: N
authors.lastname: Takayanagi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sugita
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D009569:Nitric Oxide / Q000378:metabolism; D011244:Pregnadienediols / Q000008:administration & dosage / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D000068299:Salmeterol Xinafoate; D012720:Severity of Illness Index; D013147:Spirometry; D016896:Treatment Outcome
chemical_list: D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D009569:Nitric Oxide; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000420:Albuterol